Senate Republicans Look Down Uncertain Path On Health Care

It's increasingly unclear what will happen next in the Republican push to repeal key parts of the Affordable Care Act. President Trump and Senate Majority Leader Mitch McConnell have each called for a full repeal of Obamacare only to backtrack and suggest they're still trying to pass a replacement plan. NPR's Scott Detrow has more from the Capitol on what might or might not be next for health care.

SCOTT DETROW, BYLINE: Senate Republicans wanted to vote next week on something. It could be an outright repeal of Obamacare. It could be a newer version of their Better Care Reconciliation Act. But right now neither of those options have the votes they need to pass. So what happens next? Here's Wisconsin Republican Ron Johnson.

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RON JOHNSON: I think people are now keeping things pretty close to their vest. It doesn't make a whole lot of sense to get out there too far ahead of - what is it? - out in front of your skis. Is that the...

DETROW: But as the Republican repeal and replace push teeters back and forth between life and death, there are growing calls for a different approach. Earlier this week, 11 current governors - five Republicans, five Democrats and an independent - sent a letter to the Senate. They're calling for a more limited bipartisan effort aimed at stabilizing existing health insurance markets. That caught the attention of North Dakota Democrat Heidi Heitkamp, who recently spoke to CNBC.

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HEIDI HEITKAMP: Those governors have to administer these programs. They're bipartisan. Bring in the governors. Listen to what they have to say. And let's start fashioning this together.

DETROW: Several sitting senators used to be governors themselves. Some of them got together earlier this week to map out a possible bipartisan compromise that could look a bit like the suggestion in the letter. Delaware Democrat Tom Carper is one of the recovering governors, as many of them call themselves.

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TOM CARPER: We - each of us have run Medicaid programs. We've been responsible for making sure that the people in our states do receive access to affordable health care. And the governors tend to be sometimes a bit more pragmatic and maybe just a little bit less partisan.

DETROW: Any sort of bipartisan plan to come out of meetings like that would be much different and much more limited than what Republicans have been talking about for months. West Virginia Democrat Joe Manchin was part of the meeting and talked to MSNBC.

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JOE MANCHIN: I don't know if the Democrats will vote to repeal. We're not going to throw the baby out with the bathwater. The baby just needs a diaper change. The baby doesn't need to be drowned.

DETROW: But a few Republicans feel like it's all or nothing, and their opposition helped sink the latest version of the bill.

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RAND PAUL: The bottom line is, we ran over and over and over again to repeal Obamacare.

DETROW: All year, Kentucky Republican Rand Paul has been leading the push to repeal as much of the existing health care law as possible. And given how long Republicans campaigned on that message, it's clear GOP leaders are going to keep trying to do it as long as there's a glimmer of hope it can happen, no matter how dim and remote that glimmer may appear to be right now. Here's Majority Leader Mitch McConnell leaving a meeting with President Trump this week.

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MITCH MCCONNELL: Well, it's pretty obvious we've had difficulty in getting 50 votes to proceed. But what I want to disabuse any of you of is the notion that we will not have that vote next week.

DETROW: So it's only if that vote happens and fails that a bipartisan effort could become a realistic possibility. But if that window does open, Connecticut Democrat Chris Murphy thinks a bill could be crafted.

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CHRIS MURPHY: Well, I mean there's a yin and a yang to disengagement from the White House. It doesn't help the Republicans to get a bill passed, but it might actually help us get a bipartisan agreement. And without the White House involved, it allows us to, you know, talk a little bit more effectively to each other.

DETROW: President Trump hasn't been committed to one approach. He's shifted from praising the measure the House passed to calling it mean, to calling for a repeal-only bill, to calling for a replacement plan. But one clear trend has remained. The president really wants to sign something into law. Scott Detrow, NPR News, the Capitol.